My work site was three flights below ground level, taking me into the bowels of the earth. There, beginning at 6 a.m., I began my shift in the surgical suites at the world's largest Naval hospital, Balboa, in San Diego, California. I had joined the Navy Nurse Corps while a senior in college and after graduation I accepted a two year tour of duty at Balboa. In those 12 subterranean operating rooms I helped repair every human insufficiency and imperfection from brains to bowels.
Most of our patients were military recruits or the horribly maimed veterans from Vietnam. This was a teaching hospital, 2,000 beds, filled with “learning experiences” for surgical and anesthesia residents. It was 1967 when many treatments and techniques were primitive and crude compared to today's advanced refinements.
I recall one patient in the holding area awaiting his turn under the knife. He had a sudden cardiac arrest. The chief of anesthesia, Dr. John, jumped on the gurney, straddling the patient's torso while plunging a scalpel into his chest. Dr. John used all his fingers to spread the ribs, and then to my horror-struck disgust, he grabbed the heart and began squeezing it. Blood was spurting far and wide. Dr. John was loving it! He had a flair for the dramatic as I had _ been warned by senior nurses.
His performance confirmed that reputation. The patient died, a victim of Dr. John's theatrics. Or failed heroics, depending on your point of view.
Dr. John taught his students methods of achieving anesthesia without putting the patient under general anesthesia. Regional blocks could be performed anywhere on the body, rendering small sections insensitive to pain. I witnessed stomach surgery and breast removals accomplished without any anesthetic agents, only narcotics, oxygen and paralyzing drugs.These cases were done in this manner simply to show the residents that they could be.
Some surgical candidates are in such poor shape that anesthesia could finish them off. This was a teaching hospital, after all.
Dr. John was a tall and lanky man with a facial complexion that was gaunt and scabby. His feet were 16 inches long. He dabbed his shoes with so many layers of white polish that they were always flaking, making him look as though he was walking through snow.
Every week we received dozens of Navy and Marine recruits who amazingly all had pilonidal cysts. This type of cyst is an abnormal sac filled with hairs in the deep layers of skin, most often occurring at the end of our tailbones (the coccyx), perhaps a remnant of the times when pre-humans did have tails. I found it strange that so many recruits had pilonidal cysts. But then I realized that these were phantom cysts, an excuse for Dr. John to teach saddle blocks which numbed the buttocks, perineum and inner thighs.
The recruits had no idea they were having unnecessary surgery or that they were “teaching tools.”
Before they were positioned for the saddle blocks, Dr. John examined each patient's abdomen paying particular attention to the umbilicus. His eyes lit up with glee when he found one to his liking. Using his index finger and nail, he scraped out the belly button lint, rolled it into a taut little ball, and deposited it into a quart sized mayonnaise jar which was half full of this.